Meta-Analysis Of Complications After Rhinoplasty Using Different Materials

Background The nose is located in the middle of the face and plays an important role in facial aesthetics.With the improvement of living standards,people’s requirements for their appearance are also gradually increasing.There is no absolute standard for nasal aesthetics,which is usually beautiful with a high back of the nose and a round nose.In real life,there are a variety of nose shapes,including upturned nose,saddle nose,hooked nose,short nose and so on.In order to have a good-looking nose,the nose can be remodeled by surgery.With the development of technology,more and more materials are used for rhinoplasty,which can be divided into two categories: human tissue and non-human tissue.Because costal cartilage is abundant and has relatively strong supporting force,costal cartilage is often used as a suitable human tissue material for rhinoplasty.In the process of costal cartilage extraction,it is inevitable to make a surgical incision in the chest,which may not be accepted by some patients,so the emergence of allogeneic ribs solves the problems of these patients very well.At present,the most commonly used allogeneic ribs include irradiated allogeneic costal cartilage and fresh frozen costal cartilage.At present,the non-human tissue materials used for rhinoplasty mainly include expanded polytetrafluoroethylene,silica gel and high-density porous polyethylene.As an implant for augmentation rhinoplasty,silicone has the advantages of good plasticity and easy carving,but the silicone prosthesis has no micropores and human tissue can not grow into it.Finally,the silicone prosthesis is wrapped in a capsule to achieve the effect of stable assumption.Both expanded polytetrafluoroethylene and high density porous polyethylene have many micropores,which are conducive to the growth of human tissue,thus achieving a more stable effect.These materials mentioned above are common augmentation rhinoplasty materials at present.The systematic evaluation and Meta analysis of postoperative complications of different materials are mainly focused on the pairwise comparison of autogenous ribs,expanded polytetrafluoroethylene,silica gel and high density porous polyethylene,and limited by the number of literatures,more systematic and comprehensive Meta analysis can not be carried out.In this paper,autogenous ribs,irradiated allogeneic costal cartilage and fresh frozen costal cartilage were classified as human tissue materials(HT),and expanded polytetrafluoroethylene,silicone and high density porous polyethylene were relocated to non-human tissue materials(NHT).The incidence of complications after augmentation rhinoplasty was analyzed by Meta,in order to provide a strong basis for selecting suitable rhinoplasty materials in clinical work.ObjectiveThe complications of augmentation rhinoplasty with different tissues and materials were systematically evaluated by Meta analysis,which provides a powerful basis for the selection of rhinoplasty materials in clinical work.MethodsEmbase,Pub Med and other databases were searched from the establishment of the database to September 2022.The literatures were screened according to the inclusion criteria and exclusion criteria,and the quality of the included literatures was evaluated with reference to the Robins-I scale.finally,the included literatures were analyzed by metaprop method through stata software.ResultsA total of 80 articles were included in the retrospective study of 9531 patients,including 1514 cases of autogenous costal cartilage(ACC),974 cases of irradiated allogeneic costal cartilage(FFRC),287 cases of fresh frozen costal cartilage(IHCC),2668 cases of expanded polytetrafluoroethylene(Gore-Tex),1711 cases of silicone,2377 cases of high density porous polyethylene(Medpor),2775 cases of human tissues and 6756 cases of non-human tissues.Evaluation indexes included displacement,infection,warping,extrusion,hypertrophic scar,pneumothorax,re-correction)and total complications.The following results were obtained by Meta analysis: the infection rate of human tissue materials after augmentation rhinoplasty was higher than that of non-human tissue materials,the infection rate of FFRC augmentation rhinoplasty was the highest and that of Gore-Tex was the lowest.The transposition rate of non-human tissue materials after augmentation rhinoplasty was higher than that of human tissue materials.The transposition rate of Silicone was the highest,while that of Gore-Tex and FFRC was lower.The extrusion rate of non-human tissue materials after augmentation rhinoplasty was higher than that of human tissue materials.The extrusion rate of Medpor augmentation rhinoplasty was the highest,while that of Gore-Tex and FFRC was lower.The second operation correction rate of human tissue material after augmentation rhinoplasty was higher than that of non-human tissue material.The correction rate of second operation after IHCC augmentation rhinoplasty was the highest,and that of FFRC augmentation rhinoplasty was the lowest.The overall complication rate of human tissue materials after augmentation rhinoplasty was higher than that of non-human tissue materials.The overall complication rate of IHCC augmentation rhinoplasty was the highest and that of FFRC augmentation rhinoplasty was the lowest.The curvature of human tissue material after augmentation rhinoplasty was the highest in ACC and the lowest in FFRC.The absorption rate of human tissue after augmentation rhinoplasty was the highest in IHCC and the lowest in FFRC.The incidence of chest hypertrophic scar after ACC augmentation rhinoplasty was 3.2%.The probability of pneumothorax after ACC augmentation rhinoplasty is almost zero.ConclusionThe incidence of postoperative complications of non-human tissue materials is not significantly different from that of human tissue materials,so it is a kind of safe and effective rhinoplasty materials.Compared with other non-human tissue materials,Gore-Tex has a lower incidence of complications after augmentation rhinoplasty.When choosing non-human tissue materials as rhinoplasty grafts,priority should be given to using Gore-Tex.In human tissue materials,FFRC has fewer complications and lower incidence of complications than ACC,so it is a good substitute for ACC.The overall incidence of complications after IHCC is the highest,while the overall incidence of complications after Gore-Tex and FFRC is lower.The absorption rate was the highest after IHCC and the curvature was the highest after ACC.